Local program appears to reduce medical care costs, length of hospital stays

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Updated: 10:19 AM EDT Jun 14, 2017

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WEBVTT L CENTER HASFOUND A SIMPLE SOLUTION TO HELPTHEIR TINIEST PATIENTS.>> YOU DON'T NEED A MEDICALDEGREE TO DIAGNOSE THIS PROBLEM-- >> THERE YOU GO.>> OR PRESCRIBE A TREATMENT.>> SHH, SHH, SHH. >> WHEN SHE PUTS THAT BABY ONHER, THE BABY RELAXES.THE BABY FALLS ASLEEP.>> DR. ELISHA WACHMAN IS ANEO-NATOLOGIST AT BOSTON MEDICALCENTER.SHE SAYS ALL INFANTS BENEFITFROM CUDDLING, BUT FOR BABIESBORN WITH OPIOIDS IN THEIRSYSTEM, CUDDLING PROVIDESCRITICAL CARE.>> TO LEAVE THEM ALONE BYTHEMSELVES, THEY'RE MORE LIKELYTO CONTINUE TO CRY, TO HAVEALTERED SLEEP.THEY WOULD HAVE A DIFFICULT TIMECALMING DOWN ON THEIR OWN.>> AT BMC, THE MAJORITY OFPREGNANT MOMS UNDERGOINGADDICTION TREATMENT TAKEPRESCRIBED OPIATES TO HELPSTABILIZE THEIR SYSTEM.IT'S THE CURRENT STANDARD OFCARE FOR ANY PREGNANT WOMAN INACTIVE OPIOID USE RECOVERY.>> THE DOWNSIDE OF THESEMEDICATIONS IS WHEN THE MOTHER DELIVERS, THEBABY IS SUDDENLY CUT OFF FROMTHAT SUPPLY OF OPIATES AND CANEXPERIENCE WITHDRAWAL.X CHELSEA PHILLIPS DELIVERED TWOCHELSEA PHILLIPS DELIVERED TWO-- >> CHELSEA PHILLIPS DELIVEREDTWO HEALTHY BABIES AT BMC WHILETAKING SUBOXONE.>> I WUV YOU.>> BUT KNOWING HER BABIES WOULDGO THROUGH OPIOID WITHDRAWALAFTER BIRTH WAS DEVASTATING, ANDDEPRESSING.>> IT'S ALMOST AS THOUGH YOU'REBEING PUNISHED FOR DOINGSOMETHING TO GET YOURSELFBETTER.>> NATIONALLY, THE NUMBER OFDELIVERIES INVOLVING OPIOIDS HASINCREASED TO ABOUT 5 BABIES FOREVERY 1,000 BIRTHS.IN MASSACHUSETTS RIGHT NOW, THATNUMBER IS MUCH HIGHER, 20 BABIESFOR EVERY 1,000 BIRTHSTHE COST TO CARE FOR THESEINFANTS IS SIGNIFICANT.AFTER DELIVERY, MANY BABIES ARETRANSFERRED TO A NEONATALINTENSIVE CARE UNIT, OR NIC-U,FOR MONITORING.THE TYPICAL AVERAGE FOR THEIRSTAY IS 22 DAYS.ABOUT 50% TO 80% RECEIVE OPIATESLIKE METHADONE OR MORPHINE TOEASE THEIR WITHDRAWAL.THE AVERAGE BILL, MORE THAN$93,000 PER INFANT.BUT AT BOSTON MEDICAL CENTER,MATERNAL INSTINCT HAS REPLACEDMEDICAL INTERVENTION WITHREMARKABLE RESULTS.>> THERE'S NOTHING ABOUT THESEBABIES THAT NEEDS INTENSIVECARE.USUALLY ALL THE BABY NEEDS ISSOMEONE TO HOLD THEM.>> DOCTORS HERE ENCOURAGEMOTHERS TO CUDDLE THEIR BABIESTO EASE THEIR WITHDRAWAL.>> SO THAT MEANS THAT THE PARENTIS HOLDING THE BABY, DOING A LOTOF BREASTFEEDING AND WE'VE SEEN A HUGE, IMPROVEMENT IN OUTCOMES BYPROMOTING THIS AS REALLYFIRST-LINE TREATMENT FOR THESEBABIES.MOST OF THE TIME YOU'RE ABLE TOELIMINATE THE MAJORITY OF THESYMPTOMS BY SIMPLY DOING THAT.>> THE PROOF BABIES BORN WITH, OPIOIDS IN THEIR SYSTEM STAYAT BMC FOR 9 DAYS, NOT 22.ONLY 30% REQUIRE MEDICATION FORWITHDRAWAL, NOT 50% TO 80%.AND KEEPING BABIES WITH MOMINSTEAD OF SENDING THEM TO THENIC-U DROPS THE AVERAGE COST OFCARE DRAMATICALLY.AT BMC, IT'S ABOUT 20,000 P-- $20,000 PER INFANT, NOT$93,000.>> IT'S LIKE YOU'RE GOING BACKTO BASICS.JUST KEEP THEM TOGETHER.BABY IS GOING TO DO BETTER, YOUKNOW, AND MOM IS GOING TO FEELMORE ENGAGED.>> AND WHEN THE MOMS NEED ABREAK, OR HAVE TO LEAVE THEHOSPITAL TO CARE FOR ANOTHERCHILD, THERE'S A LONG LIST OFVOLUNTEER CUDDLERS, PRACTICALLYBEGGING TO HELP.>> IT'S THE BEST PART OF MY DAY.>> JAIME SULLIVAN AND LEONIEHOYO ARE THE LUCKY ONES.THEY'RE IN THE POOL OF 150VOLUNTEERS, ALL ON STANDBY TOCUDDLE.>> AND THE MINUTE YOU PUT THEMIN YOUR ARMS AND YOU CUDDLETHEM, THEY TOTALLY CALM DOWN ANDTHEY SLEEP FOR THE REST OF YOURTIME WITH THEM.SOME OF THEM JUST STARE AT YOUAND KIND OF MAKE THE BABYNOISES, WHICH IS AMAZING.>> LEONIE ALSO STUDIES MEDICINE AT BOSTONUNIVERSITY.>> SO WE'RE ACTUALLY SEEING THATSOMETHING JUST LIKE HUMAN TOUCHCAN REALLY MAKE A HUGEDIFFERENCE IN THESE BABIES'LIVES.>> SHE ORGANIZES A GROUP OFMEDICAL STUDENTS WHO TAKETWO-HOUR CUDDLING SHIFTS, OFTENLATE AT NIGHT.>> AND I KNOW SOME OF US WILLSING TO THEM OR TELL STORIES ORREAD THEM BOOKS.AND IN THAT MOMENT TO ME, IT'S,THEY'RE JUST ANY OTHER YOU KNOWNEWBORN.>> A GIFT OF GOOD HEALTH TOBABY, AND MOM.>> I DIDN'T LEAVE HER SIDE VERYOFTEN, YOU KNOW, BUT IF I DID, IWANTED TO KNOW THAT IF SHECRIED, SOMEBODY WOULD BE THERETO HELP HER.AND IT'S A GOOD FEELING KNOWINGTHAT SHE'S NOT ALONE IF I CAN'TBE THERE FOR HER.SO, VERY GRATEFUL.MARIA: -- ED: SOMETHING SIMPLEAS CUDDLING.IF YOU'RE INTERESTED INVOLUNTEERING TO CUDDLE THESEBABIES AT BMC, GET IN LINE.THE WAITING LIST ALREADY HAS 150

Hospital 'cuddlers' volunteer to hold babies born exposed to opioids

Local program appears to reduce medical care costs, length of hospital stays

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Wachman said all infants benefit from cuddling, but for babies born with opioids in their system, cuddling provides critical care.

"To leave them alone by themselves, they're more likely to cry, to have altered sleep," she explained. "They would have a difficult time calming down on their own."

At BMC, the majority of pregnant moms undergoing addiction treatment take prescribed opiates to help stabilize their system. It's the current standard of care for any pregnant woman in active opioid use recovery.

"The downside of these medications is when the mother delivers, the baby is suddenly cut off from that supply of opiates and can experience withdrawal," Wachman said.

Chelsea Phillips delivered two health babies at BMC while taking Suboxone, a drug taken daily to reduce opioid dependence.

However, knowing her babies would go through opioid withdrawal after birth was devastating and depressing.

"It's almost as though you're being punished for doing something to get yourself better," Phillips said.

Nationally, the number of deliveries involving opioids has increased to about 5 babies for every 1,000 births. In Massachusetts right now, the number is much higher --- about 20 babies per 1,000 births.

"Typically, in-house at any one time, we have two or three babies," Wachman said. "Where we used to see maybe 50 to 70 babies per year, now on average, 120 to 130 babies per year."

The cost to care for these infants is significant.

After delivery in most hospitals, many babies are transferred to a neonatal intensive care unit -- or NICU -- for monitoring.

The average stay is 22 days. About 50 to 80 percent receive opioids like methadone or morphine to ease their withdrawal. The average hospital bill is $93,400 per infant.

"There's nothing about these babies that needs intensive care," Wachman said. "Usually, all the baby needs is someone to hold them."

Doctors at BMC encourage mothers to cuddle their babies to ease the withdrawal.

"So that means that the parent is holding the baby, doing a lot of breastfeeding," Wachman said. "And we've seen a huge improvement in outcomes by promoting this as really first-line treatment for these babies. Most of the time, you're able to eliminate the majority of the symptoms by simply doing that."

Wachman said the data supports the hospital's philosophy.

Babies born with opioids in their system stay at BMC for nine days, not 22. Only 30 percent require medication for withdrawal, not 50 to 80 percent.

Keeping babies with mom instead of sending them to the NICU also drops the average cost of care dramatically. At BMC, it's $19,655 per infant, not $93,400.

"It's like you're going back to basics," Wachman said. "Just keep them together. Baby is going to do better and mom is going to feel more engaged."

When parents need a break or have to leave the hospital to care for another child, there's a long list of volunteer cuddlers practically begging to help.

"It's the best part of my day," said Jaime Sullivan.

She and Leonie Hoyo are two of the lucky ones in a pool of 150 volunteers, all on standby to cuddle.

"The minute you put them in your arms and you cuddle them, they totally calm down and they sleep for the rest of your time with them," Sullivan said. "Some of them just stare at you and kind of make the baby noises, which is amazing."

Hoyo also studies medicine at Boston University.

"We're actually seeing that something just like human touch can really make a huge difference in these babies' lives," she said.

"I know some of us will sing to them or tell stories or read them books," she said. "And in that moment to me, they're just any other newborn."

That cuddling care provides a gift of good health to baby and mom.

"I didn't leave her side very often," Phillips recalled, holding her daughter, now three months old. "But if I did, I wanted to know that if she cried, somebody would be there to help her. And it's a good feeling knowing that she's not alone if I can't be there for her. So, very grateful."

If you're interested in volunteering to cuddle the babies at BMC, get in line. The waiting list already has 150 people.